The discriminate use of amalgam for filling teeth [microform]

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TH^

DISCRIMINATE USE OF

^M^LGIA.M

FOR

FILLING TEETH

BY W. GEORGE BEERS, L. D. S.

SURGEON DENTIST,

RK 544
B4

Potttreat :
NTED BY JOHN LOVBLL, St. NICHOLAS STREKT.

1871.

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CANADA

NATIONAL LIBRARY
BI6LIOTHEQUE NATIONALE

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TBI

DISCRIMINATE USE OF

A.MJS.T.GrA.M.

1>0S

FILLING TEETH,

BY W. GEORGE BEERS, :.. D. S.

SURGEOIf DEMTI9T.

PRINTED BY JOHN LOVELL, St. NICHOLAS STREET.

1871.

About a year ago, Mr. H. M. Bowkcr published an article on the use of amalgam
for filling teeth, in which he asserted:

1. " That whoe-nr used ^Amalgam' was unskilful, ignorant and dishonest."

2. " That the ' Royal College of Dental Surgeons of Ontario,' and the 'Dental
Association of Quebec,' (Province), advocated and encouraged its use ; and that
nearly all the Dentists in Canada advocated its use."

3. " That he did not use it."

This method of advertising one's self is not at all rare ; but the effort to depreciate
the Dental Institutions of the Dominion, and the private practice of one's competi-
tors, has, I am happy to say, had its origin in Cuuad". in this first literary attemi-t
of Mr. Bowkers'.

In replying to Mr. B.'s first article, quotations were given from the leading prac-
titioners of the day in Europe and America, favoring the proper use of amalgam.

The accompanying article was written to refute personal and other assertions in
his second article.

The fact that amalgam was once virulently opposed, even by leading men, U
poor argument against its use now. How much of the dental practice of the
present day, like much of medicine and surgery, was sneered at as visionary
twenty years ago I

AMALGAM FOR FILLING THKTH.

BV W. OEO. BEIiBB, L.D.8., HOflTBEAL.

FROM THE CANADA JOURNAL OF DENTAL SCIENCE.

The revival of the venerable views on amalgam, and the specious but
fallacious arguments adduced again,', it, which any one can read almost
verbatim in old numbers of the Amcrica7i Journal of Dental Science, is
to me like turning over the leaves of a dusty folio, which has been laid
aside for half a century, and finding between two of the pages a dead,
dry fly — a veritable blue-bottle. Mr. Bowker " rings out the same old
changes," and harps on the same effete strain as did his dogmatic masters
of thirty years ago. To the dental profession the question is a trite and
worn-out theme. Common sense and superior intelligence have almost
unanimously ignored the prejudiced tirade against amalgam 2>cr se ;
dispassionate investigation and discussion have removed the unreasonable
opposition to i^s discriminate use, except from the n 'nds of one solitary
individual in Ca.iada, and a " corporal's guard" in the United States :
and it must I ^ remembered tliat there are always a few men in every
profession, who assume a superior intelligence to the rest of their col-
leagues, but whose professional history, with rare exceptions, does not
generally present any proofs of their great superiority, other than what
they themselves assume. Thirty years ago there were probably two hun-
dred dead opponents of amalgam, when there were not over 1,000 dentists
on the continent, and they poorly educated ; to-day, though there arc pro-
bably 30,000 dentists — hundreds of them having had the benefit of colle-
giate education — yet there is only one in Canada, and a few in the States,
who hold the extreme views expressed in Mr. B's. article. Mr. B., would
therefore, have us infer that the dental profession has actually retrograded ;
that the intelligence of those who recanted their old views is not so great
to-day as it was thirty years ago ; that thirty years' college and associa-
tive reform has done nothing for its intelligence! It would occupy an
entire number of the Journal to give even a bare epitome of the bitter
" Amalgam Controversy" of 1842-45, the vulgar personalities it engen-
dered, the defamation it produced — which Mr. B. seems to hayj
imitated in regard to our Canadian Dental Societies — and the injurious
tendency of the affair on the progress of the dental profession. To
le-discuss the whole subject of amalgam would, 1 am aure, be an unneces-

sary concession to an opponent who cannot offer one original argument, and
who has to resort to arguments which have lonj^ ago been refuted, and
which the enlightenment of the profession utterly ignores. However, I
have no objections to lay bare a few of Mr. B's misstatements, an>l I beg
a careful reading from even the most prejudiced.

I was prepared for the array of quotations from the minutes of defunct
societies, old dental periodicals, et cetera, to which my opponent is at lant
reduced, and which he now submits as fresh testimony (!) agniust the
use of amalgam. I will take it for granted that Mr. B. has never
used amalgam, as it will more conveniently allow me to dispose of his
arguments. His dernier resort is precisely what I wanted, to show that
not only has he made rash statements in reference to the views still held
by some of the strong anti-amalgamitcs of 1845, but that his views of
amalgam hav : not kept pace with the dispassionate investigation and
intelligence of the times, which has led almost all of the old opponents
who are living to so modify their practice as to use the filling.

I freely confess to a great want of respect for old authorities in den-
tistry, and should be as much disposed to regulate my practice by what
was gospel in 1845, as to follow the vagaries of Celsus, or pin faith to
the chemical speculations of the 16th century. My opponent appeals
with deference to old writers, who enunciated principles and practices
when the science of dentistry was at its dawn, and much of whose asser-
tions are mere theory, easily disproved by first year students, and who
are more cherished for what they did in smoothening the way to progress
than for any positive authority they now possess.

And yet we do find dentists in praatice who continue to destroy all
exposed pulps ; to extract all teeth afiFected with chronic periodontitis ;
to treat hyper-sensitiveness of dentine with arsenic; to cram arsenic
around the neck of roots of teeth, in order to cause absorption of the
alveolus, previous to attempting their extraction ; to use the old key of
Garengeot almost exclusively ; and to follow many other antediluvian
principles, simply because Harris or Mrs. Grundy so advised, and because
they have not the independance to think for themselves, or the liberality
to concede to others who differ with them the barest possibility of being
in the right. They make dentistry a science of speculations rather than
a science of facts, and are as tenacious, not only of their views on amal-
gam, but on every other dental question, as if there was concentrated
in their brains an incarnation of sagacity, equal to that of the seven sages
of Greece stewed down together in iEson's chaldron. The one distilled
drop of otto of roses from a million blossoms is not a circumstance to
them.

Ab I showed in my first article, Dr. Parmly used precisely the same
arguments thirty years ago as Mr. B. endeavoured to startle the read-
ers of the C. M. J. with as original, and neither Mr.B. nor any one else
has ever been able to add one whit ; excepting the proportions of amalgam
as given by my opponent— 04 parts of mercury to 36 of silver— which
are, I will admit, " purely original : his figures, however, remind me of
the story of the weaver, who added the year of our Lord at the top of
his page to the amount of his profits, and who got astray in the small
itemofof $18G0. On the 19th July, 1842, Dr. Pahmly wrote: "I
vnce prepared some amalgam, and filled a dead tooth with it for Mr. N.,
of New York, and he is the only person in the world that can exhibit a
tooth ever touched by me with it ; having proved its deleterious oflFects
I uniformly condemn it, and have condemned it for many years." Now
here the great anti-amalgamitc exposes a specimen of the scientific rea-
soning indulged in on amalgam. Ho admits he only used it once, and
in a dead tooth, (and yet saved that tooth,) and then, with characteristic
logic, concludes that he proved its deleterious effects from more theory
and this one case. Mr. Bowker, however, does not need even to test
the material for himself He has the op' lions of authors, such as Harris
and PloaoTT, who participated in the amalgam war of 1842, and who
cannot conveniently recant, because they are dead ; the opinions of Dr.
Parmly, who has not been in the practice of dentistry for over twelve
years, and who does not now presume to offer himself as an. authority ;
he has old volumes of the American Journal of Dental Science, which
are as dear to him as the Koran to the Mahometan ; he has resolutions
against amalgam of old societies passed during the Amalgam war, which
certainly cannot repeal them, because the constant bickering ruined their
usefulness, and they have been defunct for two decades ; he has old
opinions of eminent dentists; but the peculiarity about it is that the
American Journal of Dental Science of to-day rejeccs the dictum of
the American Journal of Dental Science of 1842, and the eminent
dentists whom Mr. B. quotes as having said such hard things against
amalgam in 1842, have recanted those hard words, and now use " the
poison !" — " So much for" Mr. H. M. Bowker.

I must reiterate the regret expressed in my first aifticle, that my oppo-
nent found it necessary in relieving his mind of his opinions on a scien-
tific question, to impute "ignorance, want of skill, and dishonesty,"
pointedly to our Canadian Dental Associations, and to all who were not
exactly of his opinion ; and to assert, with that innate modesty which
characterizes great men, that as all the dentists in Canada, except
himself, used amalgam, therefore he was the only skilful and honest one

6

loft in the Dominion ! With such contributions to the polite literature of
the dental profession I shall not attempt to compete. But this assertion
compels me again to remove the impression his articles were intended to
convey, viz. ; that amalgam is par excellence used indiscriminately by
those who use it at all, and that those «vho use it with discrimination
are equivalent to those who use nothing else. lie also endeavours, in
true 1842 fashion, to make his readers believe, that because I defend the
use of amalgam at all, I defend its exclusive use by quacks. Very
gentlemanly, indeed.

Every honest dentist accepts the very simple proposition, which is
not at all original with Mr. B., but was made and accepted before ho
was born, or dentistry was a regular profession — that gold is decidedly
the best material for the teeth in every case where it can be used. I
mean used so as to preserve the tooth and not so as to fall out in a few
weeks or even years ; used so that the fact of gold being in the tooth
is unmistakable, while the fact that the decay has not been half
removed or the filling not properly conden.sed against the parieties of the
cavity, is unmistakable too. It is rather trite to present the fact that
the principle of every honest dentist — assuming that the public really
believe there are other honest dentists in Canada besides my modest op-
ponent— is to use gold for filling teeth as much as possible ; and also that
the principle of those who use amalgam, is to use it mostly in teeth
which my opponent admits he would extract.

Mr. B. extols, tin-foil in lieu of gold, and docs not seem to think
that galvanic action can be excited in the mouth with gold and tin as
well as with gold and silver ! I never yet saw a tooth that could be well
.filled with tin, but that could be better filled with gold. I have seen fill-
ings of tin quite as discoloured as bad unclcansed amalgams. Circum-
stances occur where a soft filling is an absolute necessity, unless the tooth
is extracted. The principal consideration in favor of tin over gold is the
one Mr. B. seems to despise in »malgara, viz., cheapness. There is no
medicinal virtue in gold-foil. To be of use at all it must be thoroughly
consolidated, and classes and conditions of decayed teeth exist which are
too frail to bear this requisite consolidation, and yet which with a filling
easily introduced can be made useful for mastication for lifo. Now, no
honest dentist would use amalgam in a front tooth, for the simple reason
that a front tooth is more exposed ; and the most precious, most orthodox
filling is demanded. Amalgam in some mouths will discolour on thesui*-
face but in the large majority of cases where a good amalgam is properly
inserted, it does not discolour. It is more liable to discolour in approximal
cavities, because the tooth-brush cannot reach these jjoints. However^

several of the preparations of gold, Buch as rponge gold, &c., much used
by some dentists, will become as black as ink on the surface. Under no
circumstances would I prefer to insert tin-foil in a front tooth ; gold can
be just as easily inserted in every case.

The opponents of amalgam meet with frail cavities which they cannot
fill with either gold or tin-foil, and they either extract the tooth or fill it
with a preparation of gutta pcrcha and silex ; or another compound called
oxy-chloride of zinc, — a preparation of refined borax, quartz, French
white zinc, which is calcined ; and to the frit formed, calcined zinc is
added, and the laixture made by forming a paste with a solution of
dry salt, chloride zinc and water. Neither of these can make permanent
fillings, and I have seen many cases where teeth were plastered up with
these destructible articles, and deluded the patient into the belief that
they were securely filled, when the edges were breaking away, decay
creeping in, and destruction ensured, where good amalgam would have
saved them. Take very large cavities in the molars ; the labial and pos-
terior sides broken away. To fill these properly with gold would necessi-
tate an expenditure of time and material which few people in Canada, at
present, appreciate sufficiently to pay for. And here I would say that in
one family of four children, in Montreal, well known to Mr. B., I inserted
56fillings- none amalgam,— all of which, with the exception of 8, had been
filled with gold, and oxy-chloride of zinc, by an anti-amalgamite who con-
siders himself something superior, about two years before they came into
my handf). In the teeth of one young man, well known to Mr. B., I re-
placed 10 gold fillings which had been inserted by the same dentist as thfi
above case, about eighteen months before. Now, if a dentist inserts such
gold fillings, and charges the highest price, surely he had better have let
^hcm alone, and surely amalgam would be better for Mm, at least, to use.

There are a class of dentists who have a class of custom among the
poor. If they fill the teeth of the poor with any other soft filling than
amalgam, they deceive the patient as to the permanency of the filling ;
if thfiy use gold or tin exclusively, neither the cost of 'he former nor the
labor of either can be remunerated. And what then ? Either the dentist
must starve, or the teeth of the poor must be consigned to Mr. B's.
scientific way of escaping an impediment, viz., extraction.

I wish emphatically to remark, that I do not and did not defend amal-
gam In toto. There is nut an honest dentist in the land but denounces
its indiscriminate use, and will vcjniee when snine noii-iiiet;illic sift
filling as good can be discovered to replace it. I perfectly agree that there is
too much used, just as most of pliysicians aurce that there is too much
medicine useil. lint thfre are poca'ly (pialififd dentists as well as

8

physicians, and you cannot regulate tlie practice of either in the respec-
tive particulars. The abuse of a medicine is no argument at all for its
abolition, or wha*^^ would be left of the pharmacopoeia ? Our Canadian
dental societies were organized for the express purpose of elevating
poorly qualified dentists to the highest standard they are capable
of attaining, but Nr. B. consistently ignores their usefulness and
defames their reputation lu Cch Canada Medical Journal. Can he divine
a better way to chanf^., any u'alpractice or mistaken practice than by
giving them gratuitous instruction and clinical education ? Any den-
tist can show from the work of ** cheap dentists " and some who esteem
themselves superior, such abominable specimens of gold fillings as to lead
many to condemn gold for filling. Mr. B. is satisfied to look at the bad
operations or failures of others with amalgam. Has he no perception
for the like in gold ? and do all gold fillings preserve the teeth ? This
dodge of classing those who use amalgam occasionally, with those who use
it exclusively is worn out.

A question arises here which it may be as well to dispose of. Can
Mr. B.J be so ignorant of the proportions of amalgam as to believe
what ho absurdly asserted in his first article — "When the mixture is
subjected to the highest pressure in order to remove the free mercury, the
amalgam then contains a preparation of 64 parts of mercury to 36 parts
of silver?" What physician believing such to be the case, but would con-
demn amalgam, as it would never harden in the tooth, and would
certainly be swallowed. If Mr. B. is not ignorant of the absurdity of
these figures, what were his motives in publishing such a statement,
associated as it was with the other assertion that nearly all the dentists
in the Dominion except himself, used it?

I -jonsider it my businessasadentisttoregard the preservation of even a
single tooth, in the most of cases, as highly as a physician would a human
life. The very end and essence, the summnm bonum of the honest den
dist is to save the human teeth, and conservative dentistry is far above the
mere mechanical. Any quack may extract a tooth ; every one cannot fill
it, even with amalgam, so as to preserve it. Mr. B. admits with bucolic
innocence, that there are teeth which cannot be filled permanently with
anything he now uses in his practice, — for it is a fact that other soft
fillings than amalgam are not permanent — and that rather than fill a tooth
with amalgam he would extract it ! There is dental science for you
with a vengeance I And from " the expositor of the abuses of dent-
istry " too ! Now according to this scientific admission, my opponent
must have extracted hundreds of teeth, because he would not use amalgam,
when thousands of proofs exist everywhere in this very city, and many

9

proofs in the teeth of physicisins and their families of Montreal, that
amalgam has healthily preserved teeth from further decay, which would
have been consigned to Mr. B's. forceps.

Like nearly all opponents of amalgam, he presumes to speak ex cathedra
on a point of practice which he "conscientiously affirms" he has never
tried ! He offers his theoretical knowledge against the practical experience
of the thousands of other dentists who are teachers in colleges, eminent
operators, leading writers of the present day, not of 1 842 ; many of whom
are also medical graduates, and who are the acknowledged head of the
profession in America and Europe. I should like my opponent to
explain the qualifications he possesses to justify him in this assumption.
Is he not like the critics who judge a book from the title page, and who, be
it marked, are invariably the nvjst dogmatic and intolerant critics of all ?
Which testimony in the use of a medicine would be most worthy of con-
fidence,— that of the comparatively obscure man who avows his opinions
to be due to second- hand text books, back numbers of old periodicals,
old opinions of writers, which they recanted, and resolutions of defunct
societies, or that of the men who have the lead in every progressive
dental movement, who are the acknowledged leaders in this most pro-
gressive period of dentistry, who, with one or two exceptions, repudiate
the assertions of the former ? Mr. B. would positively have the world
believe that mere opinions formed thirty years ago are more reliable than
as many years practical observation and experience !

There are points and paragraphs in Mr B.'s last article which I cannot
quietly pass over — they are too tempting to omit. He labor?: liard
for arguments, and gives as his reason for accusing the " Royal College
of Dental Surgeons of Ontario " of encouraging the use of amalgam, that
" in the Canada Journal of Dental Science," vol. 1. page 210, are to be
found questions put to the students on amalgam, in the said College.
The wrong use of the plural instead of the singular number does not seem
to rub against the grain of his conscience whenever it can make an argu-
ment appear stronger. There were not " questions " asked. There was
only the one question asked. '• What is an amalgam," and this not by the
exarairor on Operative Dentistry whose office is to " encourage" the proper
materials for filling teeth, but by the examiner on Chemistry, whose
office is to treat his questions from a purely chemical point of view
But what has he to say about his false charge against the Dental
Association of this province ? Nothing more than that as I was Secretary
of the Association at the time, and because I edited the Dental Journal,
therefore the Society of which I was Secretary" advocated and vindi-
cated the use of amalgam !" Very logical, indeed. Very original logic.

10

Peculiar to Mr. H. M. B. And yet, Mr. B. conveniently overlooks the
important fact that the only reason I wrote on amalgam was to disprove
his false accusations, and that he hadpublished the false accusations in the
Canada Medical Journal before I wrote a line on the subject, " So much
for" Mr. H. M. B. How monotonous it is for some men to tell the truth f

He also says "the American Journal of Dental Science " has always in
its articles on the subject taken a most decided and uncompromising
stand against the use of amalgam," and yet in the second paragraph of
his article, he says that the present editor of the Journal "thinks I have
taken an extreme view, and believes that amalgam can be mfely used in
teeth which are mere shells." He mentions Harris, Westcott, Dwin-
ELLE, S. Brown, Pigqott and Parmly, all of whom he says, " repudia-
ted the use of amalgam, and those 0/ them now living remain unchanged
in their opinions on this question." We 1, Harris, Brown and Piogott
are dead; Pwinelle refuses to discuss the subject; Parmly is no
longer in practice, and Westcott, who is still a leading man in dentistry
and who was actually the brightest man of them all, has recanted his old
opinions. The ^'American Journal of Dental Science " in reviewing Mr.
B's. first article said as follows :

" This article is somewhat severe upon the " Royal College of Dental
Surgeons," and the Dental Societies of Canada. Who Mr. BowJcer is
ice do not know ; perhaps the " Canada Journal of Dental Science " can
enlighten us ; but whether Mr. B. is qualified by professional experience
and vanrsflgation to make a report upon this subject or not, much that
he says is true, but at the same time we think that he has taken an ex-
treme view of the case.

''Although no advocate for tliu iiiui!3v.riminate use of amalgam and
believing that tin-foil is much superior as a cheap material for filling teeth,
yet we think this compound may be used in teeth which are mere shells,
so far gone that no other metal can be safely introduced, and that it will
preserve such teeth for a time afc least, especially where their extraction
is contra-indicated for some good reason.

" On the other hand such fillings should never be used in teeth which
it is possible to fill with either gold or tin-foil ; and in no case should
amalgam be used in front teeth, or in the pulp cavities of teeth, or in
the proximity of a living pulp.

"When properly prepared and properly introduced, instead of amalgam
fillings containing 64 parts of mercury to 36 of silver, as Mr. B. asserts,
the proportion of mercury need not and should not bo half so great.

The objections urged against this compound in Mr. B's. article would
certainly hold good, if the amalgam used at th% present time was as im-

11

pure as that employed ten or twelve years ago. But a great ipiprove-
ment has been made not alone as regards the parity of the ingredients
composing amalgam, but also as to the manner of preparing and introdu-
cing it into the teeth.

" The following is the best method for using this material in cases
where its use is indicated." TIk.i follows tlio detailed description of the
" method of use. Now I ask any one of common sense if that is the
uncompromising condenmatiou " of amalgam Mr. B. would make his
readers believe the American Journal of Dental Science still main-
tains. This extract is from the pen of the present editor of the A. J. D.
S., — Prof. GoRGAS, who is also Vrofessor of Dental Surgery and Dean of
the oldest Dental College in the world, that of Baltimore. Knowing
^ Mr. Bowker's high appreciation of the A. J. D. S., and all connected

with it, I wrote to Prof. Goroas and received the following answers to
questions, Dec. 2, 1870.

Question — Do you not believe that amalgam will preserve a healthy
tooth?"

Answer (by Professor GoRQAS.) — " I do, if it is properly inserted
into a properly prepared cavity."

Question. — " Do you think it better to extract a tooth, as Mr, Bowker
says he would do, rather than fill it with ainalgaiu."

^4.».swcr (by Professor GoRGAS.) — "I should prefer having a tooth
tilled with amalgam, to having it extracted, and would so advise my
patients."— " So much for" Mr. H. M. Bowicer.

Dr. Westcott's writings and sayings seem to have great weight with
Mr. B., who s.iys, " Dr. Westcott, nn authority — he having tilled
the Professorial Chairs of Operative and Mechanical Dentistry, in the
Dental Colleges of Baltimore and New York — is one o{ the original and
most indefatigable writers against all preparations of mercury for tilling
teeth. What does he say ? His utterances are not uncertain; what lan-
guage can be more dicisive? He, in the most emphatic manner, says,
" No man who has so little self-respect aa to use this amalgam to any
considerahle extent will refuse to stoop to any species of quackery which
will contribute to his pockets," &c. Precisely so say I; and every
honest dentist joins in condemnation of the men who use amalgam to
such a considerable extent as to seldom use anything else. Dr. Westcott
was once an editor of the A. J. D. S. He is a great authority on
amalgam, Mr. B. tells us, and the latter quotes what he said twenty-tive
years ago ; a quarter of a century does not enlighten one according to
Mr. B.'s theory. I trust, however, hia weak nerves will survive the

12

following little shock, and that Dr. Westoott will continue to hold a
placo in his memory, Mr. B.'s "authority," like all sensible aa'l
unprejudiced men, has the manliness to acknowledge his erroneous views
on amalgam, and is now using " the poison." He was the Secretary of
the " American Society of Dental Surgeons," which passed the resolution
against amalgam, and his name is appended to that resolution with Dr.
Parmly's ; and so zealous a seconder Avas he of the bitterness of the latter
that he was named his "•fubis Achates.''

^^ Syracuse, Jan. 16, 1871.
Mr. W. Geo. Beers —
Dear Sir,

I am in receipt of your letter upon the sub-
ject of the use of amalgam. I would have replied more promptly could
^ have found time to write you as fully as the subject demanded; for
having somewhat modi/ted my views and nractice within the last fifteen
or twenty years upon the subject, I hardly liked to give you the views I
now entertain without giving you fully my reasons for such modification,
and the restraints and limits I still hold in re reuoeto tbeir employment.
Should I get time to do so, I will at some ''uture time write out my
views fully upon this subject, stating when, ' only when, how, and
only how, I use amalgam for filling a tooth.

Very truly yours,

A. WESTCOTT.
May I not return the salutation of my opponent, and say "So much
for"— Mr. H. M. Bowker,

In another place ray opponent says, two leading Ontario dentists — one
the co-editor of the G. J. D. S. — " agree in the main with me as to the
use of A." Well, it seems necessary to reiterate that every honest den-
tist agrees that the indiscriminate use of amalgam is wrong, and that
the use of Mr. Bowker's amalgam proportions is not only wrong, but
worse. But how hard up my opponent must be for arguments, when he
has to quote such a statement of dentists V}ho actually use amalgam.

He courteously says, I do not tell the truth in saying that the
"American Society of Dental Surgeons" did "ot unanimously carry the
resolution of 1845 condemning amalgc»m. The facts are these (my readers
can interpret them as they please) : sixty-one members voted dead against
the resolution when it was first brought up, and after these sixty-one
had either resigned, or were expelled for non-compliance with the rash
and silly movement, the remainder then " unanimously" (I) carried their
own resolution. Mr. B. also denies that this resolution was finally
rescinded : here is my authority for saying that it was. At a special

meeting of the Society, held in Baltimore, 25th March, 1850, Drs.
Westoott, Townsend, and I. H. Foster were appointsd a Committee
to report on the propriety of rescinding the amalgam pledg:' At Sara-
toga, in August, 1850 (the following appears in the New York Dental
Recorder, vol. 5, page 69) : " The Committee appointed ?t the called meet-
ing in Baltimore to consider the propriety of rescinding the amalgam
pledge, reported through their chairman, Dr. E. Townsend, which
report, after considerable discussion and recommittal for the purpose of
amendment, was finally adopted, and the following resolution along with
it:—

" Resolved — That the several resolutions adopted by the " Society of
Dental Surgeons," at the annual meetings held 1845-4G, having the effect
of enforcing subscription to the protest and pledge against the use of
amalgams and mineral paste fillings for teeth, be, and the same arc,
hereby rescinded and repealed."

Common sense has also repealed it : science peremptorily repeals such
rubbish in her onward march.

Mr. B. cites resolutions passed in the dark ages of dentistry
by the "Virginian Society of Surgeon Dentists" and the " Mississippi
Vahey Association of Dental Surg3ons." Pray, who were they ? and
where are they now ? " Down among the dead men."

My over-anxious opponent asks, " Is the Canadian Dental College
prepared to say that the members of their kindred colleges in the United
States are ignorant empirics ?" That will not do, Mr. B. The Dental Col-
leges of the United States, as their reports show, do use amalgam, though
discriminately ; the Canadian College has not used it as it has hap-
pened ; therefore Mr. BowKEti alone is the one who charges " the mem-
bers of their kindred colleges in the United States with being ignorant
empirics."

During a recent trip through the United States I met most of the
very leading men in the dental colleges, associations, the journals, &c.
and had especial opportunity of finding out the facts as to the use of
amalgam. T found one bitter old gentlemen who T nted forth the ancient
refrain against its use ; but I also discovered that he never tried to save
exposed pulps of teeth, and that in the great improvements in practice
he had no faith or share. All unanimously advocate discrimination in
its use; use of gold in preference wherever it can bo used; but the old
theories I found entirely exploded, and yet the very proper precaution
prevailed not to extol it, lest it should lead to over-estimation. Pro-
fessor Atkinson, of New York — a very giant among giants in dentistry,
whose excellence in operating, keen diagnostic and general scientific

u

attainments nont can fairly dispute, and who frequently receives $50
and $100 for a single gold filling, and who, therefore, has every reason,
were he selfish, to denounce amalgam — w rites to me lately the following
replies to questions : —

1. "Will not a properly prepared amalgam, properly inserted, pre-
serve a healthy tooth ?" Answer, hy Professor A. — ''Yes, as well a»
any other filling.''

2. " Do you believe there is any possibility of ptyalism from amalgam
in the teeth?" Answer, hy Professor A. — " Nay, verily."

3. " Is amalgam not used by very eminent dentists for patients who
cannot pay for gold, and for certain classes and conditions of decayed
teeth which cannot be well filled with gold ?" Answer, by Professor A.
— " Yes, and by those of deserved eminence."

I can produce any quantity of such testimony from mostly all the
leading dentists: one more will suffice for the present: it is from one
of the keenest obiervers and rising men of the profession. Dr. S. P.
CutlerJ Professor of Chemistry, Metallurgy, Microscopy, and Histology
in the New Orleans Dental College. He says, " Undoubtedly I do think
amalgam may not only bo used, but with most decided benefit in a great
many instances; where gold cannot be used I would use amalgam for
permanent use. I have had several discussions with Dr. Geo. Watt
on the subject of amalgam, and I always differed with him ; his conclu-
sions were not at all satisfactory to me. I have used amalgam for 25
years quite extensively, and never in any instance have I seen a single
well-marked case of disease, either local or general, from its use in my own
hands, or in any others. I have seen cases that have been attributed to its
use, but without satisfactory evidence. I believe that good amalgam
fillings in haiUy decayed teeth, thoroughly introduced i<nd well finished
after hardening, to be superior to any other filling, and will preserve such
teeth much longer than gold or anything else, especially in back teeth.
There are various reasons for the conclusions well-founded."

A dealer in dental materials in Ontario tells me that he has sold amal-
gam to nearly every dentist in Canada, though there are some dentists
who deal elsewhere ; he " sells to the best as well as the poorest. My sales
in Canada amount to about 500 ounces per year." The largest dental
depot in the world writes tome, Deo. 2, 1870: " We do sell amalgam
to many of the leading practitioners iii the United States ; it is very exten-
sively used by some of the profession, who, as contributors or editors of
dental journals, profes.sors in dental colleges, &c., are regarded as eminent
dentists. Our sales amoi.nt to between 5,000 and 10,000 ounces per
year." And it must be rcniembcrcd that there are perhaps a score of
dental depots in the United States.

16

Some of the leading dentis^t in t'oe United States have recentlj
introduced amalgams of their own composition to the profession.

Tho Dent 1 Journals contain advertisements of amalgam recom-
mended by leading dentists ; and if the Canada Dental Journal doei*
advertise amalgam, it is only what is what done by every other similar
journal in the world, and Mr. B. must be very simple if he thinks a
pul''.?her would refuse any proper advertisement. He has raked up
all the petty little things he can think of to strengthen his case, but they
have only served to weaken it. He twists a quotation around and
endeavours to make it appear that the words of another whom I quoted,
are original with me, and says " As long as I have been a member
of the profession, I was not aware that pure gold would become highly
cxydized when used as plugs in the teeth, or would have any medicinal
effects on the constitution," Who said it would ? Neither I nor the
writer whom I quoted. My quotation said, " With equal propriety it
might he urged against gold, that, because ichen highly ooci/dlzed it
becomes a powerful medicinal agent, therefore it should not be used a*
a filling for teeth." This was in connection with a refutation of the
assumption that because there is mercury in amalgam, it must necessarily
have a mercuralizing influence. Mr. B. has something now to learn
about gold as well as silver, if he is not aware tb .t gold can become
oxydized ; and that it can produce medicinal effects on the constitution.
Is not the ter-chloride of gold a powerful irritant poison ? And Mr. B. is
not aware that there can be produced an oxide of gold ! Did he never
know that a preparation of gold muriate or chloride of gold has been
used as an antisyphilitic, in obstinate scrofulous and cancerous glandular
enlargements, exostoses, &c., and that it is rubbed on the tongue or
gums ?

In my last article I referred to John Tomes, F.R.S., author of "-Tomes
Dental Surgery," &c., Nasmyth, well-known for his physiological investi-
gations; Saunders, dentist to Her Majesty ; and other eminent English,
German, French and American authors and practitioners ; Professors
Pierce, Buckingham, MoQuillen, Fitch, 1<'lagg, Allen, &c , all of
them the very leading talent, and admittedly so. Mr. B. amuses me by
asking the pompous question : " Are they practitioners of any high
repute?" Perhaps the "American Journal of Dental Scior' >," who
does not know " who Mr. B. is " will answer his question. I slu 1 like to
know who are practitioners of high repute, when we exclude such men as
the above, and the host of eminent dentists, who hold the same views ot
amalgam.

I am sure that xMr. B.'s (juery will be a source of amusement to the

16

dental prot'ession in general. Possibly he btlieves that as Le- -according
to his owp assertion — io the only slcilful ana honest Dentist in Canada,
60 the few extrcipc opponents of amiilgam in Ac United States are the
only intelligent ones left since the duys of 1842.

Mr. B. says " I ask Mr. Bkers, " Are the physical conditions
of the human frame d'.forent in 1870 from what they were in 1847?
If the malpractice of uaialgam was determined in 1847, what ciroim-
stances can possibly mako its use sound and good practice in 1870 ?"
Very easily answered. 1st. I am prepared to debate the former question
in the affirmative, at any time. But allowing that they have not
undergone any change, I would answer that the common sense and
intelligence of 1870, such as shown by Dr. Westcoit, is infinitely in
advance of 1847, and I pity him if ho doubts it. But may .. ujk him to
point out the divine law which made the dictum of 1847 binding on the
generation of 1871; and if it was '* determined in 1847" that there
wap no real hope of preserving an abscohsed tooth, why we make efforts
and succeed in saving them in 1871. Pshaw? such a question is only
fit for a habitant to ask, who clings to his wooden plough, and his poor
agricultural ideas, because his fathers taught him to do so.

How does the matter stand to-day ? In favor of the discriminate use
of amalgam, we have the very leading men in every country in the
world ; while on the other hand, they freely admit that gold is the best
filling when it can boused to save the tooth. The opinion of John Tomes
alone is worth ten times more than that of any prejudiced investigator in
• America or elsewhere.

I have ore serious question to ask Mr. B., which, with the other
points, I beg him not to evade. If, as he asserts, he has always con-
sidered the use of amalgam injurious, and has known in his thirty years
practice that it was used, and even very much more used formerly than
now, why he waited until the present organization and progressive move-
ment of the dental profession in Canada — in which he shirked a share —
to unburden his mind of his opinions ? He had such a superabundance
of conscientiousness all of a sudden, that he felt "it would be a violation
both of duty and conscience to remain silent," — j/et he remained so a
quarter of a ceatury, and was impelled to come out as an "expositor of
the abuses of dentistry," at the very nick of time when dental associations,
a college, and a journal were vigorously working for education and reform.

One question more, and I have done with Mr. B.

The early writers against amalgam held the view that because there wa«
mercury in it it was p >isonous. Mr. B. quotes Dr. Geo. Watt
and Dr. Tapt, of Cincinnatti extensively. Dre. Watt and Taft say that

17

because there mercury in amalgam it Is poisoriou3. Mr. B, also suysr
that the mercuij in the compound is the reason it is poisonous.

Well, Dr. Watt says of red vulcanite whi-jh is used .la a base for arti-
Icial teeth, tlat because there is mcrcurj in it, it is poisonous. Dr. Taft
says it is poisonous. Now wh;it about Mr. Bowker? Oh ! he ha? been
using this very red vulcanite since its introduction, and though Dr«.
Watt and Taft, who are so great authorities with him against amalgam
say it is poisonous, and Prof. Silliman says that one-third jf the whole is
sulphide of mercury, and though a host of dentists, chemists and physi-
cians arc running the rubber question in the United States just as am-
algam was run in 1845, and though Drs. Watt, Taft, &c., say it causes
salivation, produces injurious constitutional effects, &c., yet Mr. Bowker
places it, not in the bony substance of a tooth, but covering the mucous
inembran*? of the hard palate ! And this tirade against red vulcanite
•' because there is mercury in it " is of 1870 and 71, not of 1845. Will
Mr. Bowker explain this remarkable inconsistency ? Personally I do
not believe that if *he rubber is properly vulcanized, kept clean, and
removed occasionally — as nature never intended the roof of the mouth to
be covered with a foreign base — that it^is injurious or poisonous ; because
before the mercury or sulphur can be set free the base must undergo
decomposition. The opposition to its use in the States originated when
the Goodyear Rubber Co. compelled dentists to pay an annual tax,,
and its principal opponents are those who have prepared substitutes to
take its place, and which they are anxious to sell. But still there is sul-
phide of mercury in red vulcanite, and how does my opponent reconcile
his opposition to amalgam, which keeps hard and perfect for years, with
his use of a material which wears away in the mouth ; and we know the
sulphide of mercury used ip the rubber is frequently adulterated with
red lead, and bisulphide of arsenic — poisons which are soluble in the
mouth.

In conclusion, I hold that if any dentist cxtr icts every tooth he cannot
fill with gold, and which can be filled with amalgam, he is guilty of gross
injustice to his patients, and gross malpractice. This is the opinion of
the leading dentists of the day, and while determining to use gold in every
possible case, they are well aware of the risk incurred in extolling a filling
so easily introduced as amalgam. There are " cheap dentists " who cannot
use gold, and to whose souls a defence of any soft filling is a sweet conso-
lation. I do not defend amalgam, or anything else in the hands of the
" cheap dentists." But I know that they may make a permanent filling
of amalgam, while I know that they cannot make one of gold. Not to
mince the matter, the majority of the present extreme opponents of amal-

18

gam, ore all old-foiry practiti«ncr?, who esteem their a^e anil past reputa-
tion sufficient reason to dignify tlie most absurd assertions. The progress
of dentistry never was much aided by their eflFort«, and never will be.
They have fallen behind, and have failed to keep pace with that intel-
ligence and freedom from prejudice, which characterize the meu who
noic rank highest in the dental profession of every country in the world.

[Among the scores of opinions on Amalgam sent us by the leading
men in the profession, we value the following from the pen of one of
widely recognized ability. Though written very hastely and not exactly for
publication, it evinces something deeper than second-hand assumption.]

3Iy Dear tMR, — Your favour of 22 prox. came to hand day before
yesterday.

I have been experimenting since yesterday morning on amalgams.
First, I put into nitric acid one part to four of water, a lump of hard
amalgam ; second, hydrochloric acid one part to two of water ; third,
sulphuric acid ouo part to two ; fourth, strong vinegar. A lump of dry
amalgam has remained in each since yesterday, the only effect noticeable
la either is a slight action of the nitric acid, darkening slightly the
surface, without any perceptible change; none of the others have under-
went any perceptible change, but remain clear and white.

Now any of these preparations are sufficiently strong to act with
energy on teeth in the same length of time, and any of these acids
would if retained in the mouth any length of time, excoriate the entire
mucous surfaces. Good amalgams are composed of pure tin and silver,
and amalgamated with pure mercury. Water does not decompose mercury
silver or tin lo any perceptible extent. Nitric acid dilute acts on silver,
also mercury separately and less so on tin. Heat facilitating the action
when the three are combined, as in amalgam, the acid action is greatly
lessened. I do not believe that any action of the fluids of the mouth
is sufficient to produce any mercurial salt capable of acting injuriously
to t'le slightest extent, even in cases that have been repeatedly salivated
by taking mercurials; if so, I have never witnessed a case during thirty-
two years professional observation.

I have seen a filling but a short time since, made of silver filings and
mercury, that had been in a lower bicuspid twenty-five years, the filling
being perfectly sound and the tooth all round except near the gum
where a cavity below had nearly reached the filling. This filling was
very dark on the surface, but on running a file over it slightly it gave a
pure sound white surface, in consequence I left the filling in and filled

below it. This dark surface was the result of the silver oxidizing
slightly.

Remove any amalgam filling from any tooth and file the surface, and
the filed portion will become white and metallic. In order to get
protoxide of mercury, which is the only one of consequence, lueroury
must be heated up to 600 degrees with fiee access of air, then red pre-
cipitate is formed, which is the protoxide, and on raising the heat higher,
this oxide is again decomposed into the simple elements.

.To form calomel, which is a sub-chloride, subnitrate of mercury is
precipitated by common salt ; it is also formed by otL-'r processes. Proto-
chloride of mercury, or corrosive sublimate, n)ay he made in several
ways. When metallic mercury is heated in chlorine gas it takes fire and
burns, producing this salt.

From the above formulas it will be seen that mercury is not readily
acted upon by any fluids that may exist in the mouth, as these fluids
always contain at least from 800 to 900 parts of water in 1000 parts, so
that any acid or any other agent contained in this fluid could absolutely
have no action of any momeiit ; neither in tit^ or silver ; the latter turns
dark from an oxide being formed in some mouths much more rcudily
than in others; some mouths scarcely acting on a silver plate at al!.
Youman says that mercury slowly vaporises at all temperatures above 40
degrees; some say ail temperatures above 06, The vaporisation goes on
mere rapidly as the temperature is raised up to the point of ebullition
662.

All the apprehension that need give us any concern in connection with
imalgam fillings is the vaporisation during the process of hardening, some
of which undoubtedly will be inhaled into the lungs, as this vapor must
be lighter than air or it could not be a vapor at all. The amount that
might oe inhaled would be so insignificant that it would not do any
mischief, as it would bo carried out of the lungs again even if it passed
the entire rouids of the circulation.

Workers, in-quick silver are short-lived, owing to the fact that they arc
constantly in an atmosphere charged with these vapors, which no doubt
keep their systems saturated during their working hours, which in a few
causes a total lesion of nutrition, the hair and nails fall off, the hard tis-
sues become saturated ; the periostium fails to nourish the bones, and the
poor wretches die from exhaustion.

The insignificant amount of this vapor escaping from a fine amalgam
filling could produced no injurious effect. The vapor will salivate when
BuflBcient has been inhaled, which is the first effect of allmost all forms
of mercury, however introduced into the system. Mercury in its action is

20

an irritating stimulant, to the glands more especially, the liver primarilr,
the oral secondarily.

March 31. — All the specimens have now been in the acids 48 hours,
none of them are in the least aiTocte'l, except that in the nitric acid,
which is nearly all decomposed, with some precipitate of tin I suppose,
at the bottom. It will be seen that in 24 hours there was seurculy any
action at all by the nitric acid, and now none at all by any action of the
other acids.

I think thc.o conclusions are sustained by demonstrable facts as given

above.

S. P. CUTLER, M.D., D.D.S.

Professor of Chemistry, Metallurgy, Microscopy and
Hiptology in New Orleans Dental College.
New Orleans.

liiiUlii^ittttMii